PRC Outreach

Updated 8 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 5 July 2018 and was announced. The provider was given 48 office hours’ notice because the location provides a personal care service to people who lived in the community. We needed to be sure that we could access the office premises, and meet relevant management personnel. Following the inspection, we spoke with another director of the company and made phone calls to eight people and six relatives to gain their views on the service they received.

The inspection was undertaken by one inspector. During the visit we spoke with five staff members, the registered manager and senior carer, company secretary, plus one of the board of directors. We spoke with a visiting health and social care professional during the inspection.

We reviewed a range of records about people’s care and the way the service was managed. These included the care records for three people, staff training records, three staff recruitment files, staff supervision and appraisal records, minutes from meetings, quality assurance audits, incident and accident reports, complaints and compliments records and records relating to the management of the service. We also looked at the results from the most recent customer satisfaction survey completed by people using the service.

In preparation for our visit, we checked the information we held about the service and the provider. This included statutory notifications sent to us by the registered provider about incidents and events that had occurred at the service. A notification is information about important events, which the service is required to send us by law. We also reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plan to make.

Updated 8 August 2018

This announced inspection took place on the 5 July 2018. It was announced 48 business hours in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. Our last inspection of the service was carried out on 16 October 2015 2015. At that inspection we rated the service as good. At this inspection we found the service remained good.

Penwith Respite Care (PRC) is a Domiciliary Care Agency that provides care and support to adults, in their own homes. The service provides help and support with people’s personal care needs in the Penzance and surrounding areas. The packages of care that PRC provide range from 30 minutes a day to 24 hour care dependant on the person’s care needs.

PRC alongside the domiciliary care service, run a café in the local community and provided outreach support. Therefore, not everyone using PRC receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The provider had developed strong links with the local community. They worked alongside other organisations to ensure they followed current good practice in the delivery of people's care. The management team had a role in promoting the importance and value of social care locally. Strong links with the community had been formed via the café. People told us that they were supported by staff to meet with friends in the local café, which reduced social isolation. Some people worked at the café with support from staff which enabled employment opportunities.

At the time of our inspection 33 people were receiving a personal care service. Support is provided to people with a physical or learning disability from the age of 18 tears to older persons. These services were funded either privately or through Cornwall Council or NHS funding. There were 29 staff employed some of those were office based to coordinate and manage the service.

People were extremely satisfied with the quality of the service they received and the caring approach from staff. People told us; "They are friendly, reliable, always on time and thoroughly conscientious.” Relatives were also complimentary, commenting “I had trouble finding the right care for my [relative] and at last she’s got it. They are amazing, they are adaptable, local, understand [relatives] needs that no one else has and if there is a emergency they help out.” Another relative said “The staff know [person’s name] so well, I know that staff look after her well and I don’t need to worry anymore, I can relax and know she is being cared for by caring and competent staff.”

People told us they had not experienced a missed care visit. The service had robust and effective procedures in place to ensure that all planned care visits were provided. The service's visit schedules were well organised and there were a sufficient number of staff available to provide people's care visits in accordance with their preferences.

People told us that their visits were on time but there were 'rare occasions' when care staff could be late for their planned visits. However, people, and relatives, did not have a concern regarding this as they understood that any lateness was due to care staff needing to provide extra support to a person in an emergency or due to travel issues, especially in holiday seasons. People told us that PRC office staff would phone them if a care worker was going to be late which gave them reassurance that their visit would continue. PRC operated an on-call system outside of office hours. Care staff told us managers would respond promptly to any queries they might have.

People received care and support from a consistent team of staff with whom they were familiar. Staff arrived on time and stayed for the full time allocated. People spoke positively about the staff that supported them and told us they were always treated with care, respect and kindness. Staff were respectful of people’s privacy and maintained their dignity. Staff had developed good relationships with people and were familiar with their needs, routines and preferences

Staff were respectful of the fact they were working in people's homes. The service offered flexible support to people and were able to adapt in order to meet people's needs and support them as they wanted.

There were processes in place to protect people and the security of their home when they received personal care, including staff carrying identification. People received information about who they should expect to be delivering their care so they were aware of who was due to call upon them.

Safeguarding procedures were in place and staff understood their responsibilities to safeguard people from abuse. Potential risks to people's safety and wellbeing had been assessed and managed.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided. Accidents and incidents were reported and reviewed to reduce the risk of an incident occurring again.

Medicine procedures were safe. The service supported people with their medicines by prompting them. Records showed when prompts had been made in the daily records at people’s homes.

Staff were recruited in a safe way and available in sufficient numbers to meet people's needs. Staff were supported by a system of induction, training, one-to-one supervision and appraisals to ensure they were effective in their role.

Staff knew how to ensure each person was supported as an individual in a way that did not discriminate against them in any way. People's legal rights were understood and upheld. Everyone told us staff ensured their dignity and privacy was promoted.

People told us staff had sought their consent for their care. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received relevant training and understood the principles of the Act.

People's care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people's care needs. The care plans included objectives for the planned care that had been agreed between the service and the individual. All of the care plans we reviewed were up to date and accurately reflected each person's individual needs and wishes. The service's risk assessment procedures were designed to enable people to take risks while providing appropriate protection.

Staff supported people to have a nutritious dietary and fluid intake, assisting them to prepare and eat food and drinks as they needed.

The registered provider and management team provided clear leadership to the staff team and were valued by people, staff and relatives. There was a whole team culture, the focus of which was how they could do things better for people.

People and relatives all described the management of the service as open and approachable. People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.